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Ways of knowing the health of livestock populations: the age of surveys, 1928-65. 了解牲畜健康状况的方法:调查时代,1928-65 年。
IF 0.9 2区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-07-01 Epub Date: 2023-09-05 DOI: 10.1017/mdh.2023.20
Abigail Woods

This article advances historical understandings of health, veterinary medicine and livestock agriculture by examining how, in mid-twentieth-century Britain, the diseases of livestock were made collectively knowable. During this period, the state extended its gaze beyond a few, highly impactful notifiable diseases to a host of other threats to livestock health. The prime mechanism through which this was achieved was the disease survey. Paralleling wider developments in survey practices, it grew from small interwar beginnings into a hugely expensive, wide-ranging state veterinary project that created a new conception of the nation's livestock as a geographical aggregation of animals in varying states of health. This article traces the disease survey's entanglements with dairy cows, farming practices, veterinary professional politics and government agendas. It shows that far from a neutral reflection of reality, surveys both represented and perpetuated specific versions of dairy cow health, varieties of farming practice and visions of the veterinary professional role. At first, their findings proved influential, but over time they found it harder to discipline their increasingly complex human, animal and disease subjects, resulting in unconvincing representations of reality that led ultimately to their marginalization.

这篇文章通过研究二十世纪中期的英国是如何将牲畜疾病变成可被集体知晓的疾病,推进了人们对健康、兽医和畜牧业的历史理解。在这一时期,国家将其视线从少数几种影响巨大的应予通报的疾病扩展到对牲畜健康构成威胁的一系列其他疾病。实现这一目标的主要机制是疾病调查。与调查实践的广泛发展同步,疾病调查从战时的小规模起步,发展成为一个耗资巨大、范围广泛的国家兽医项目,它创造了一种新的概念,将全国的牲畜视为处于不同健康状况的动物的地理集合体。本文追溯了疾病调查与奶牛、农业实践、兽医专业政治和政府议程之间的纠葛。文章指出,疾病调查远非对现实的中立反映,而是代表并延续了奶牛健康的特定版本、各种养殖实践以及对兽医专业角色的看法。起初,他们的调查结果被证明是有影响力的,但随着时间的推移,他们发现越来越难对日益复杂的人类、动物和疾病主题进行约束,导致对现实的表述难以令人信服,最终导致他们被边缘化。
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引用次数: 0
On the Heart of the Hippocratic Corpus: its meaning, context and purpose. 论希波克拉底语料库的核心:它的意义、语境和目的。
IF 1.4 2区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-07-01 DOI: 10.1017/mdh.2023.22
Ryan C Fowler

Though the Hippocratic text On the Heart has garnered significant attention in the twentieth and twenty-first centuries from classicists, physicians and historians of medicine alike, no commentary on this important work currently exists. There remain, however, central questions of interpretation concerning a number of important points: in particular, how the author understands the structure and functioning of the heart.The significance of this text for the history of cardiovascular medicine can be found first in its position as being radically advanced in its portrayal of the inner structure of the heart when compared with any other Hippocratic text. At the same time, the text falls dramatically short of the discoveries of the Alexandrian researchers who studied during the Hellenistic period-that is, around the same period as this text's likely composition. In addition, this work contains the first extant description of the valves of the heart, and its detailed descriptions of a cuspid valve and the chordae tendineae have led several scholars to imagine that this text even contains evidence of either a systematic dissection of an animal heart or-what seems impossible outside of Alexandria, Egypt at that time-evidence of the dissection of a human heart.This article intends to provide a full commentary on the text by consolidating, and in some cases correcting, previous interpretive attempts to understand an often referenced, and at times misinterpreted, ancient medical treatise.

尽管希波克拉底的《论心脏》在20世纪和21世纪获得了古典学家、医生和医学历史学家的极大关注,但目前还没有对这项重要工作的评论。然而,仍然存在一些关于解释的重要问题:特别是,作者如何理解心脏的结构和功能。这篇文章对心血管医学史的意义可以首先在它的位置上被发现,与任何其他希波克拉底文本相比,它在心脏内部结构的描绘上有了根本性的进步。与此同时,该文本与亚历山大研究人员在希腊化时期(即与该文本可能的构成大致相同的时期)进行研究的发现大相径庭。此外,这部作品包含了现存的第一个关于心脏瓣膜的描述,它对尖瓣和腱索的详细描述使一些学者想象,这本书甚至包含了对动物心脏进行系统解剖的证据,或者(在当时的埃及亚历山大之外似乎不可能)关于人类心脏解剖的证据。本文打算通过巩固,并在某些情况下纠正,以前的解释性尝试来理解经常被引用,有时被误解的古代医学论文,提供对文本的完整评论。
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引用次数: 0
MDH volume 67 issue 3 Cover and Front matter. MDH第67卷第3期封面和封面问题。
IF 1.4 2区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-07-01 DOI: 10.1017/mdh.2023.33
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引用次数: 0
The 'new era in medicine': John Ryle and the promotion of social medicine. “医学的新时代”:约翰·赖尔和社会医学的推广。
IF 1.4 2区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-07-01 DOI: 10.1017/mdh.2023.21
John Stewart

John A. Ryle was Britain's first professor of Social Medicine. In the 1930s and 1940s, at the peak of his influence, he was a vigorous proponent of social medicine, then a relatively new, if contested, field. This article examines Ryle's views and activities under three broad headings: What was social medicine? What were Ryle's politics? Why prioritise medical education? We conclude with the apparent failure of the social medicine project, at least as envisioned by Ryle.

约翰·赖尔是英国第一位社会医学教授。在20世纪30年代和40年代,在他的影响力达到顶峰时,他是社会医学的积极支持者,当时这是一个相对较新的领域,尽管存在争议。本文在三个大标题下考察了赖尔的观点和活动:什么是社会医学?赖尔的政见是什么?为什么要优先考虑医学教育?我们的结论是社会医学项目的明显失败,至少是赖尔设想的失败。
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引用次数: 0
A history of thalidomide in India. 印度沙利度胺的历史。
IF 1.4 2区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-07-01 DOI: 10.1017/mdh.2023.27
Ludger Wimmelbücker, Anita Kar

In contrast to the well-known stories of the embryotoxic drug, thalidomide, in countries where it was responsible for large numbers of birth defects, there is limited information on its history in India. Its presence before 2002, when the country issued the first marketing licence for a thalidomide-containing preparation, is assumed to be negligible. This article challenges this view by showing that the drug entered the Indian subcontinent through the former Portuguese territory of Goa around 1960. We examine the subsequent development of its distribution, use and regulation in India from the mid-1960s up to the present situation. Colonial legacies are a crucial explanation for the early appearance of thalidomide on the Indian subcontinent. They also influenced its re-emergence as drug for treating leprosy reactions in India after 1965. We identify key actors in this process: the original German producer that delivered thalidomide free of charge, European doctors who worked for international non-governmental organizations, the World Health Organization (WHO), which supported clinical trials and later discouraged the use of the drug, and finally the Indian state institutions that limited its distribution and later quickly opened the way for the private sector to produce and market thalidomide and its analogues. Finally, we discuss the risk of thalidomide-induced birth defects by casting a critical look on the present state of regulatory provisions and the monitoring of birth defects in India.

与众所周知的胚胎毒性药物沙利度胺(thalidomide)的故事不同,在一些国家,沙利度胺是造成大量出生缺陷的原因,而在印度,关于沙利度胺的历史信息有限。它在2002年之前的存在被认为是微不足道的,当时该国颁发了第一个含有沙利度胺的制剂的销售许可证。这篇文章挑战了这一观点,表明毒品在1960年左右通过前葡萄牙领土果阿进入印度次大陆。我们研究了从20世纪60年代中期到现在,其在印度的分布、使用和监管的后续发展。殖民遗产是沙利度胺早期出现在印度次大陆的一个重要解释。它们也影响了它在1965年后作为治疗麻风病反应的药物在印度的重新出现。我们确定了这一进程中的关键行为者:最初免费提供沙利度胺的德国生产商、为国际非政府组织工作的欧洲医生、支持临床试验、后来劝阻使用该药物的世界卫生组织(世卫组织)、最后是限制其分销、后来迅速为私营部门生产和销售沙利度胺及其类似物开辟道路的印度国家机构。最后,我们讨论了沙利度胺引起的出生缺陷的风险,通过对印度的监管规定和出生缺陷监测的现状进行了批判性的审视。
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引用次数: 0
Medical imagery in Maximus of Tyre's Orations. 《提尔演说》中的医学意象。
IF 0.9 2区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-07-01 Epub Date: 2023-09-05 DOI: 10.1017/mdh.2023.23
Sophia Xenophontos

Imagery is an overarching feature of Maximus of Tyre's Orations which has never been the subject of systematic investigation. This paper provides a starting point by focusing exclusively on medical imagery, one of the most pervasive and instrumental types of imagery in Maximus' work that has gone entirely unnoticed in the literature to date. This paper shows that Maximus uses medicine (especially its scientific basis and historical development), the physician (e.g. his skill, provision and sensitivity towards the patient), the body (its physiology and workings) and notions of health and disease with considerable diversity and creativity, in ways that make his examples stand out in relation to earlier (Platonic) or contemporary applications of the medical parallel. It argues that the use of the medical imagery in the pedagogical context in which Maximus' Orations were performed facilitated not just clarity but also concept formation and the shaping of a moral outlook as well as the familiarisation with the proper literary references and verbal and conceptual topoi for admission into the group of the educated elite. Another main thesis is that medical imagery valorises Maximus' philosophical status and his claims to Imperial-period acculturation, thus functioning as a trademark for the rhetorical philosophy he wished to promote.

意象是Maximus of Tyre’s Orations的一个重要特征,它从未被系统地研究过。本文提供了一个起点,专注于医学图像,在马克西姆斯的工作中最普遍和工具类型的图像之一,在迄今为止的文献中完全没有被注意到。这篇论文表明,马克西姆斯使用医学(尤其是其科学基础和历史发展),医生(例如他的技能,提供和对病人的敏感性),身体(其生理和运作)以及健康和疾病的概念具有相当的多样性和创造性,以使他的例子在早期(柏拉图式)或当代医学平行应用中脱颖而出。它认为,在教学环境中使用医学意象,其中马克西姆斯的演讲是进行的,不仅促进了清晰度,而且还促进了概念的形成和道德观的塑造,以及熟悉适当的文学参考和口头和概念的topoi,以便进入受过教育的精英群体。另一个主要论点是,医学意象提升了马克西姆斯的哲学地位和他对帝国时期文化适应的主张,从而成为他希望推广的修辞哲学的商标。
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引用次数: 0
'Pearls' of the nineteenth-century: from therapeutic actors to global commodities medicinal leeches in the Ottoman Empire. 19世纪的“珍珠”:从治疗演员到全球商品奥斯曼帝国的药用水蛭。
IF 1.4 2区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-01 DOI: 10.1017/mdh.2023.17
Büşra Arabacı

Nineteenth-century physicians increasingly favoured leeching - the placing of a live leech onto a patient's skin to stimulate or limit blood flow - as a cure for numerous ailments. As conviction in their therapeutic properties spread, leech therapy dominated European medicine; France imported over fifty million leeches in one year. Demand soon outpaced supply, spawning a lucrative global trade. Over-collection and farming eventually destroyed leech habitats, wreaked environmental havoc and forced European merchants to seek new supply sources. Vast colonies of leeches were found to inhabit the immense wetlands of the Ottoman Empire, which soon became a major exporter of medicinal leeches. Following the Treaty of Balta Liman (1838), the Ottoman state moved to exert control over the lucrative trade, imposing a tax on leech gathering and contracting with tax-farmers (mültezim) to collect the taxes. British diplomats, merchants and other stakeholders protested the imposition of the tax, as had previously happened with the commodification of wildlife; their pursuit of profit led collectors and farmers to over-gather leeches, with catastrophic consequences. By the end of the century, so great had their worth climbed that the leech population faced extinction. This paper situates medicinal leeches as therapeutic actors of history and adopts an interscale approach in formulating the human-leech interaction. It offers a substantive contribution to the history of medicine, in revealing the centrality of leeches to the rise of modern medicine and global trade, but also by making visible their role in shaping imperial diplomacy and worldwide economic markets.

19世纪的医生们越来越喜欢把活水蛭放在病人的皮肤上刺激或限制血液流动,作为一种治疗许多疾病的方法。随着对水蛭治疗特性的确信传播,水蛭疗法主导了欧洲医学;法国一年进口超过五千万只水蛭。需求很快就超过了供应,催生了一种利润丰厚的全球贸易。过度采集和养殖最终破坏了水蛭的栖息地,造成了环境破坏,迫使欧洲商人寻找新的供应来源。在奥斯曼帝国广阔的湿地上发现了大量的水蛭,奥斯曼帝国很快就成为了药用水蛭的主要出口国。在《巴尔塔利曼条约》(1838年)之后,奥斯曼帝国开始对利润丰厚的水蛭贸易施加控制,对收集水蛭征税,并与收税农民(m ltezim)签订合同来收税。英国外交官、商人和其他利益相关者抗议征税,就像之前野生动物商品化时发生的那样;他们对利润的追求导致采集者和农民过度采集水蛭,造成了灾难性的后果。到本世纪末,水蛭的价值攀升得如此之高,以至于水蛭种群面临灭绝。本文将药用水蛭视为历史上的治疗行为者,并采用跨尺度的方法来制定人与水蛭的相互作用。它为医学史做出了重大贡献,揭示了水蛭对现代医学和全球贸易兴起的核心作用,同时也让人们看到了水蛭在塑造帝国外交和全球经济市场中的作用。
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引用次数: 0
Workhouse or asylum? Accommodating pauper lunatics in nineteenth-century England. 济贫院还是收容所?在19世纪的英国,收容乞丐和疯子。
IF 1.4 2区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-01 DOI: 10.1017/mdh.2023.15
Alistair Ritch

The late eighteenth and early nineteenth century witnessed a dramatic increase in the number of pauper lunatics being admitted to institutions and many mentally-ill paupers found their way into workhouses. The range of options existing for the admission of paupers, who at the time were described as lunatics or insane, included private madhouses, charitable asylums, public asylums as well as workhouses. Legislation relating to transfer from a workhouse to a one of these other institutions was ambiguous and depended on the concept of dangerousness and whether a workhouse inmate was manageable, rather than the nature of their illness. Because demand exceeded the space available because of overcrowding, workhouses and public asylums continually needed to increase provision by means of converting existing facilities or erecting new buildings. Nevertheless, the transfer of patients between asylums was commonplace and extensive. This article will explore the interface between two urban workhouses in the West Midlands of England and their local asylums from the late eighteenth until the end of the nineteenth century. It will demonstrate that, although local circumstances at any one time may have contributed to decisions on transfer, the overriding difficulty in the correct placement of pauper lunatics throughout the time period was institutional overcrowding, mainly driven by the increasing numbers of pauper lunatics.

18世纪末和19世纪初,收容机构收容的乞丐疯子数量急剧增加,许多患有精神疾病的乞丐进入了济贫院。在当时被称为“疯子”或“精神失常”的乞丐,收容他们的选择范围包括私人疯人院、慈善收容所、公共收容所和济贫院。有关从济贫院转移到其他机构的立法是含糊不清的,取决于危险的概念和济贫院囚犯是否可以管理,而不是他们的疾病性质。由于过度拥挤,需求超过了现有的空间,济贫院和公共收容所不断需要通过改造现有设施或建造新建筑物来增加供应。然而,在收容所之间转移病人是司空见惯和广泛的。本文将探讨从18世纪末到19世纪末,英格兰西米德兰兹郡的两座城市济贫院与当地收容所之间的联系。报告将表明,虽然任何时候的当地情况都可能促成有关转移的决定,但在整个期间正确安置精神失常的乞丐的最大困难是机构过度拥挤,这主要是由于精神失常的乞丐人数不断增加造成的。
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引用次数: 0
Medical fears of the malingering soldier: 'phony cronies' and the Repat in 1960s Australia. 医学上对装病士兵的恐惧:“虚伪的密友”和20世纪60年代澳大利亚的Repat。
IF 1.4 2区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-01 DOI: 10.1017/mdh.2023.19
Effie Karageorgos

The fear of the malingering soldier or veteran has existed in Australia since its first nationwide military venture in South Africa. The establishment of the Repatriation Department in 1917 saw the medical, military and political fields work collectively, to some extent, to support hundreds of thousands of men who returned from their military service wounded or ill. Over the next decades the medical profession occasionally criticised the Repatriation Department's alleged laxness towards soldier recipients of military pensions, particularly those with less visible war-related psychiatric conditions. In 1963 this reached a crescendo when a group of Australian doctors drew battle lines in the correspondence pages of the Medical Journal of Australia, accusing the Repatriation Department of directing a 'national scandal', and provoking responses by both the Minister for Repatriation and the Chairman of the War Pensions Assessment Appeal Tribunal. Although this controversy and its aftermath does allow for closer investigation of the inner workings of the Repatriation Department, the words of the doctors themselves about 'phony cronies', 'deadbeats' and 'drongoes' also reveal how the medical fear of the malingering soldier, and particularly the traumatised soldier-malingerer, lingered into the early 1960s and beyond. This paper will analyse the medical conceptualisation of the traumatised soldier in the 1960s in relation to historical conceptions of malingering, the increasingly tenuous position of psychiatry, as well as the socio-medical 'sick role', and will explore possible links with the current soldier and veteran suicide crisis in Australia.

自从澳大利亚首次在南非开展全国性军事活动以来,对装病的士兵或退伍军人的恐惧就一直存在。1917年遣返部成立后,医疗、军事和政治领域在某种程度上共同努力,支助数十万伤病员从服兵役归来。在接下来的几十年里,医学界偶尔批评遣返部据称对领取军事养恤金的士兵,特别是那些与战争有关的精神疾病不太明显的士兵态度松懈。1963年,当一群澳大利亚医生在《澳大利亚医学杂志》的通信页上画出战线,指责遣返部策划了一场"国家丑闻",并引起遣返部部长和战争养恤金评估上诉法庭主席的回应时,这种情况达到了高潮。尽管这一争议及其后果确实允许对遣返部的内部运作进行更深入的调查,但医生们自己关于“虚假的密友”、“游手”和“不负责任的人”的说法也揭示了对装病士兵,特别是受创伤的装病士兵的医疗恐惧是如何持续到20世纪60年代初及以后的。本文将分析20世纪60年代创伤士兵的医学概念化与装病的历史概念,精神病学日益脆弱的地位,以及社会医学的“生病角色”,并将探讨与澳大利亚当前士兵和退伍军人自杀危机的可能联系。
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引用次数: 0
Have we lost sleep? A reconsideration of segmented sleep in early modern England. 我们缺觉了吗?对近代早期英国分段睡眠的再思考。
IF 0.9 2区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-01 Epub Date: 2023-08-01 DOI: 10.1017/mdh.2023.14
Niall Boyce

The theory that the people of the early modern period slept in well-defined segments of 'first' and 'second' sleeps has been highly influential in both scholarly literature and mainstream media over the past twenty years. Based on a combination of scientific, anthropological and textual evidence, the segmented sleep theory has been used to illuminate discussions regarding important aspects of early modern nocturnal culture; mainstream media reports, meanwhile, have proposed segmented sleep as a potentially 'natural' and healthier alternative to consolidated blocks of sleep. In this article, I re-examine the scientific, anthropological and early modern literary sources behind the segmented sleep theory and ask if the evidence might support other models of early modern sleep that are not characterised by segmentation, while acknowledging that construction of such models is by nature limited and uncertain. I propose a more diverse range of interpretations of early modern texts related to sleep, with important implications for medical and social history and literary scholarship.

在过去的二十年里,现代早期的人们睡眠分为“第一”和“第二”两个阶段,这一理论在学术文献和主流媒体中都有很大的影响。基于科学、人类学和文本证据的结合,分段睡眠理论已被用于阐明有关早期现代夜间文化重要方面的讨论;与此同时,主流媒体报道称,分段睡眠是一种潜在的“自然”、更健康的选择,可以替代固定的睡眠时间。在本文中,我重新审视了分段睡眠理论背后的科学、人类学和早期现代文学来源,并询问这些证据是否可能支持其他不以分段为特征的早期现代睡眠模型,同时承认这些模型的构建本质上是有限和不确定的。我对与睡眠有关的早期现代文本提出了更多样化的解释,这对医学史、社会史和文学研究具有重要意义。
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引用次数: 0
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